COMMUNITY

ORGANIZING
Louricha A. Opina-Tan, MD, FPAFP
UP Manila Community Health and Development Program
COMMUNITY MEDICINE
PRACTICECommunity Medicine Clinical Medicine
Target
Tools for assessment
Possible Diagnosis
Goal of Intervention
Interventions
COMMUNITY MEDICINE
PRACTICE Community Clinical
Medicine Medicine
Target Geographically-demarcated
population group;
Biased for the vulnerable
Tool for assessment Community diagnosis
Possible Diagnosis Health concerns and the social
determinants
Goal of Intervention Community development
where health is included
Interventions Community health programs
Community organizing
OBJECTIVES
1. Explain the importance of community organizing in community
medicine practice.
2. Describe how community organizing leads to community
development.
3. Discuss the steps in community organizing.
4. Analyze the roles of a primary care physician in community
organizing.
COMMUNITY DEVELOPMENT
AND HEALTH
“Economic and social development,
based on a New International Economic Order,
is of basic importance to the
fullest attainment of health for all
and to the reduction of the gap
between the health status of the
developing and developed countries.
The promotion and protection of the
health of the people is essential to
sustained economic and social development
and contributes to a better quality of life
and to world peace.”
 Problem

community

Problem Organized community

COMMUNITY ORGANIZING
“It is a process by which a community
identifies its needs or objectives,
orders (or ranks) these needs or objectives,
develops the confidence and will to work at these needs or objectives,
finds the resources (internal and/or external)
to deal with these needs or objectives,
takes action in respect to them,
and in doing so extends and develops
co-operative and collaborative attitudes and practices
in the community.”
M Ross, 1955
 OBJECTIVES OF CO
✔ To make people aware of social realities
✔ To form structures that uphold the people’s basic interests
✔ To initiate responsible actions intended to address
holistically the various community health and social
problems.
 IMPORTANCE OF CO
Maximizes and ensures community participation and
involvement.
▪

Community resources are mobilized for community

services.
▪

Prepares people to eventually take over the management

of development programs in the future.
▪
STEPSORGANIZING
IN COMMUNITY
1. Entry in the community
2. Integrating with the people
3. Community study or situation analysis
4. Identifying and developing potential community
leaders
5. Core group formation
6. Setting up the organization
7. Strengthening the organization
A Manalili 1985
 KNOW YOURSELF
Do you believe that people have the potentials to
contribute to their own development?
▪

Do you believe that people are educable inspite of their

low educational and economic level?
▪

Do you believe that people should be given the power to

decide their own destinies?
▪

▪ Do you like working with people?

▪ Are you committed to serving the people’s interest?
 ENTRY IN THE COMMUNITY
▪ Gather some basic information about the place
▪ Culture, practices and lifestyle
▪ You should not be regarded as superior or different from the people.
Do not appear as a savior or someone who has the solutions to all
their problems
▪
 INTEGRATING WITH THE
PEOPLE
Live with them, eat their food, doing their chores, learn
their way of life
▪

Once you are introduced to the other members of the

community, gradually join their small groups and continue
▪

to expand your knowledge about the condition in that

place.
Start working with the community. Realize the hardships
and problems that the people face.
▪
 COMMUNITY STUDY OR SITUATIONAL
ANALYSIS
Facilitate the people’s participation in analyzing their
situation by letting them examine their situation
▪

themselves.
Do not limit their participation to mere answering survey
questionnaires.
▪

Help the people realize that their problems are only

manifestations of more serious and heavier problems at
▪

the national level.

 IDENTIFYING AND DEVELOPING
POTENTIAL COMMUNITY LEADERS
Observe who seem to have a deep understanding and
concern for the people of the community.
▪

Equip them with useful knowledge and experience for

their future roles as leaders by initiating regular
▪

discussions.
Slowly educate and convince the community that their
leaders must come from their ranks and not from outside.
▪
 CORE GROUP FORMATION
Form a core group consisting of the identified potential
leaders. Each member must represent a sector of the
▪

community.
This group will continue to meet until each of them accepts
the challenge to organize the rest of the community.
▪
 SETTING-UP THE ORGANIZATION
(DEVELOPING ORGANIZATIONAL
STRUCTURE)
▪ Election of leader with participation of all the members.
Educate the members to trust their organization so they
must all participate in choosing their leaders in a
▪

democratic way.
 STRENGTHENING THE
ORGANIZATION
Give the organization the chance to move and work
together on their own.
▪

Strengthen the organization until the people are truly

convinced about their collective strength.
▪

Let the people learn how to identify the issues and

problems confronting them.
▪

Let them plan the various activities they can perform

together for the common good.
▪
 Steps in Community Organizing
▪ *Know yourself
1. Entry in the community
2. Integrating with the people
3. Community study or situation analysis
4. Identifying and developing potential community leaders
5. Core group formation
6. Setting up the organization
7. Strengthening the organization
 BASIC PRINCIPLES OF COMMUNITY
ORGANIZING
▪ Principle of Felt Needs
▪ Principle of Leadership
▪ Principle of Participation
▪ Principle of Communication
▪ Principle of Structure
▪ Principle of Evaluation
Quezada, 1972
 CO PRINCIPLES
▪ Principle of Felt Needs
discover what these felt needs are and to channel these
and the people’s discontent into organization and action
▪

▪ Must be anchored in the idea of “trust in people”

A community organizer should recognize people’s inherent desire to change
their conditions to grow and develop;
▪

▪ That the people (concerned) are capable of bringing about change and that
they can define for themselves the meaning of development as well as plan and
implement its goals and objectives
▪
▪ FELT NEED vs. OBJECTIVE NEED
▪ Felt Need: Ano ang nararamdaman nilang kailangan nila
▪ Objective need: Ano talaga ang kailangan nila
▪ The people
needed. may have different perceptions of what is really
▪ status quo (of inequity)
▪ “sense of helplessness”

▪ Objective
empoweringneeds: elicited
mechanisms from
such the
as community
problem treethrough
analysis,
problem prioritization, etc.
 CO PRINCIPLES
▪ Principle of Leadership
▪ A leader is:
▪ accepted
▪ well respected
▪ has a charisma or influence to a number of people
▪ is democratic
▪ has a track record of working for the common good
▪ demonstrated capability of making things work
 CO PRINCIPLES
▪ Principle of participation
▪ actively involved in all phases of the organizing process:
▪ needs identification
▪ capability building
▪ resource identification and utilization
▪ other decisive actions to solve the problems
▪ evaluation
 CO PRINCIPLES
▪ Principle of communication
open lines of communication must be established and maintained among community
organizers, local leaders and community members
▪
 CO PRINCIPLES
▪ Principle of structure
develop an organizational structure that is simple and functional based on the needs of
the organization
▪
 CO PRINCIPLES
▪ Principle of evaluation
assess the gains of any mobilization or social action, its strength and weaknesses and to
sum-up the lesson learned
▪
 HEALTH PROGRAM AS
STRATEGY TO DEVELOPMENT
▪ Health as an entry point in broader community development efforts.
▪ Start with community “self-diagnosis”
▪ The first step toward a successful community program should
community effort toward an identification of its problems. take the form of a
▪ Itimportant
should befeature.
an awareness-creating process in which community involvement is the most
▪ Simplicity should be the keynote
▪ Selection of the program
▪ The objective is to awaken the community’ s potential and to
involvement through participation in program implementation. encourage its sense of
▪ Village health workers
▪ They are an extension of the existing health system
W Lathem (ed.) (1979). The Future of Academic Community Medicine in Developing Countries. USA: The Rockefeller Foundation.
PROCESSES / METHODS IN
CO
▪Action-Reflection-Action Session
Begins with small, local, concrete issues identified by the
people, then, evaluation of and reflection on actions taken
▪

by them.
▪ Conscientization (Consciousness-raising)
▪ development of critical awareness
an open-ended learning process carried out through
group dialogue
▪

emphasis is on the learning that emerged from actions

undertaken and that will enrich succeeding actions
▪
 PROCESSES / METHODS IN
CO
▪ Participatory and Mass-based
▪ activities that facilitates participation of the community
▪ Collective Leadership
▪ group centered and not leader-centered
 PLAGUES TO COMMUNITY
PARTICIPATION
▪ Paternalistic role of the development professionals
▪ Inhibiting and prescriptive role of the state
▪ Overreporting of development successes
▪ Selective participation
▪ Hard issue bias
▪ Conflicting interest groups within community
▪ Gate-keeping by local elites
▪ Excessive pressure for immediate results
▪ Lack of public interest
PROMOTING COMMUNITY
PARTICIPATION
▪ Demonstrate
the an
beneficiary awareness
community of their
and thestatus as outsiders
potential impact to
of
their involvement.
▪ Respect the community’s indigenous contribution
manifested in their knowledge, skills and potential. as
▪ Become
that good
assist and facilitators
stimulate and catalysts
community-based of development
initiatives and
challenge practices which hinder people from
their own initiatives and realizing their own ideals. releasing
PROMOTING COMMUNITY
PARTICIPATION
▪ Promote co-decision-making in defining needs, goal-setting, and
formulating policies and plans in the implementation of these
decisions. Seek out various sets of interests, rather than listening
only to a few community leaders and prominent figures.
▪ Communicate both programme / project successes and failures –
sometimes failures are more informative.
▪ Believe in the spirit of “Ubuntu” – a South African concept
encompassing key values such as solidarity, conformity,
compassion, respect, human dignity, and collective unity.
PROMOTING COMMUNITY
PARTICIPATION
▪ Listen to community members, especially
vulnerable, less vocal and marginalized groups.the more
▪ Guard against
aco-operative the domination
small unrepresentative of some
leadership interest
clique. groups
Encourageor
spirit and
among community leadership.watch for oligarchic tendencies
▪ Involve
partners a cross-section
in jointly of interest
defining groups
development to collaborate
needs and as
goals, and
these goals. designing appropriate processes to reach
PROMOTING COMMUNITY
PARTICIPATION
▪ Acknowledge that process-related soft
important as product-related hard issues. issues are as
▪ Aim at releasing the energy
exploiting or exhausting them. within a community without
▪ Empower
development communities
through to share
active equitably
processes in the
whereby fruits of
beneficiaries
initiatives influence
rather than the
merelydirection
receive of
a development
share of benefits
in a passive manner.
“Health administrators should be prepared to cast aside
their present preoccupation with the
medico-biological aspects of health,
and recognize their far more significant role as
agents of change in a forward-moving community.”

W Lathem (ed.) (1979). The Future of Academic Community Medicine in Developing Countries. USA: The Rockefeller Foundation.
MARAMING SALAMAT!